EP1427357B1 - Tete d'humerus modulaire a connecteur excentrique - Google Patents

Tete d'humerus modulaire a connecteur excentrique Download PDF

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Publication number
EP1427357B1
EP1427357B1 EP02719525.4A EP02719525A EP1427357B1 EP 1427357 B1 EP1427357 B1 EP 1427357B1 EP 02719525 A EP02719525 A EP 02719525A EP 1427357 B1 EP1427357 B1 EP 1427357B1
Authority
EP
European Patent Office
Prior art keywords
head
connecting member
bore
prosthesis
humeral head
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Lifetime
Application number
EP02719525.4A
Other languages
German (de)
English (en)
Other versions
EP1427357A1 (fr
EP1427357B8 (fr
Inventor
N. Kelly Grusin
Christopher Jobe
Michael L. Brooks
Felix Rivas, Jr.
Edward Duke
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Wright Medical Technology Inc
Original Assignee
Wright Medical Technology Inc
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Filing date
Publication date
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Publication of EP1427357A1 publication Critical patent/EP1427357A1/fr
Publication of EP1427357B1 publication Critical patent/EP1427357B1/fr
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Publication of EP1427357B8 publication Critical patent/EP1427357B8/fr
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/40—Joints for shoulders
    • A61F2/4014—Humeral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic humeral shafts
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2002/30108—Shapes
    • A61F2002/30199—Three-dimensional shapes
    • A61F2002/30224—Three-dimensional shapes cylindrical
    • A61F2002/30225—Flat cylinders, i.e. discs
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2002/30405—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by screwing complementary threads machined on the parts themselves
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    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30537—Special structural features of bone or joint prostheses not otherwise provided for adjustable
    • A61F2002/30538—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting angular orientation
    • A61F2002/3054—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting angular orientation about a connection axis or implantation axis for selecting any one of a plurality of radial orientations between two modular parts, e.g. Morse taper connections, at discrete positions, angular positions or continuous positions
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0069—Three-dimensional shapes cylindrical
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/0085—Identification means; Administration of patients
    • A61F2250/0089—Identification means; Administration of patients coded with symbols, e.g. dots, numbers, letters, words
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/0096—Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers
    • A61F2250/0097—Visible markings, e.g. indicia

Definitions

  • the present invention relates to shoulder prostheses. More particularly, the present invention relates to a modular humeral head with eccentric connector that allows the modular humeral head to be connected to a humeral stem with varying degrees of eccentricity.
  • a prosthesis During the procedure of a shoulder replacement operation, at least a portion of the proximal section of the humeral shaft will be replaced by a prosthesis.
  • Early shoulder prostheses attempted to directly replicate the upper portion of the humerus which they were designed to replace. Thus, like the natural upper portion of the humerus, they were typically unitary structures including a stem to be implanted within the humerus and a head to be positioned within the glenoid cavity of the scapula.
  • a modular prosthesis generally consists of two parts: a stem that is mounted into the medullary canal of the humerus, and a head component connected in some manner to the stem.
  • the head component replaces the bearing surface of the humeral head to allow the movement of the shoulder.
  • Different stem sizes and head sizes in a modular prosthesis provide the surgeon with some degree of interoperative flexibility which facilitates reconstruction of the original anatomy of the patient. With a range of stem sizes and a range of head sizes available, the surgeon can choose a particular combination to suit the anatomy of each individual without having to have a large inventory of unitary humeral prostheses.
  • U.S. Patent 5,358,526 discloses a modular humeral prosthesis comprising a humeral stem, a humeral head and a wedge-shaped spacer for connecting the head to the stem.
  • the wedge-shaped spacer includes a first face which fits a bearing face on the stem and a second face for attaching the head.
  • the head has a semi-spherical cap and a base with a conical bore. The bore is positioned off-center on the base i.e. non-concentrically relative to the head.
  • a conical stud protruding from the second face of the wedge-shaped spacer is designed to fit into the bore.
  • the present invention relates to shoulder prostheses in accordance with the features of claim 1 in which a humeral head, chosen to suit a patient, is attached to a stem' chosen to suit the resected humerus of the patient, by means of an intermediate connecting member.
  • the intermediate connecting member can be adjusted to vary the eccentricity of the humeral head to a portion of the connecting member attachable to the stem. Two degrees of eccentricity, preferably, are provided.
  • the modular humeral prosthesis generally comprises a stem to be fitted to a resected humerus, a head sized and configured to approximate the humeral head, and an intermediate connecting member for connecting the stem to the head.
  • a locking piece is provided to secure the intermediate connecting member to the head.
  • the humeral head has a spherical surface formed about an axis on one side and a flat face on the opposite side.
  • a first degree of eccentricity is provided by an opening positioned eccentrically (i.e., not centered) on the flat face of the head for receiving the connecting member.
  • the opening is preferably a threaded, shallow bore.
  • the connecting member is formed of a first portion for connection with the head and a second portion for connection with the stem.
  • a second degree of eccentricity is provided by the relationship of the second portion to the first portion.
  • the first portion for example, may be a shallow, round plate.
  • the second portion for example, a male connecting piece of substantially smaller diameter than the plate, is located non-coaxially on the plate and extends generally conically therefrom.
  • a locking piece is used to secure the connecting member in place in the humeral head.
  • the locking piece preferably, is a threaded ring that is inserted over the plate of the connecting member and threaded through the bore in the head.
  • the plate is loosely inserted into the shallow bore on the humeral head.
  • the connecting member is rotated until the desired eccentricity of the male connecting piece to the humeral head is achieved.
  • the locking piece is inserted and threaded in the shallow bore on the humeral head to lock the connecting member in place in the humeral head.
  • the male connecting piece fits into the conical cavity of the stem for, e.g., a Morse taper fit.
  • a single connecting member may provide a great variation of eccentricity of the humeral head to a portion of the connecting member attachable to the stem. This is especially advantageous in that it allows a surgeon to customize the eccentricity of the humeral head to a patient's specific morphology without requiring an extensive inventory of modular components.
  • Figure 1 illustrates a cross-sectional view of a first embodiment of the present invention.
  • a shallow bore, generally 18, is positioned non-coaxially on a flat face of humeral head 10.
  • humeral head 10 locks to a connecting member 12 by a locking piece 14.
  • Connecting member 12 includes a first portion 15 for connection with the head and second portion 16 for connection with the stem.
  • the first portion 15 may be a shallow, generally flat, round plate.
  • Second portion 16 is a male connecting piece, of substantially smaller diameter than the first portion, located eccentrically on the first portion and extending generally conically therefrom. Second portion 16 fits into a conical cavity of the stem for a Morse taper fit.
  • Locking piece 14 locks the connecting member in place in the humeral head.
  • locking piece 14 is a threaded ring that is inserted over the first portion of connecting member 12 and threaded through bore 18 in the head.
  • a peripheral shoulder of the locking piece is provided to engage the first portion of the connecting member.
  • connection member 12 To secure connecting member 12 to humeral head 10, the flat round plate is loosely fit into shallow bore 18 of humeral head 10. A first degree of eccentricity is achieved by rotating connecting member 12 until the desired offset of second portion 16 to humeral head 10 is achieved. To secure connecting member 12 in place in humeral head 10, locking piece 14 is inserted and threaded in shallow bore 18 on humeral head.
  • bore 18 is located eccentrically on the flat bottom surface of humeral head 10; that is, the axes of the spherical head and the bore are spaced apart. Bore 18 is of relatively large diameter when compared to the second portion of the connecting member. To receive the first portion of the connecting member, bore 18 is relatively shallow. Optionally, bore 18 is threaded to engage with the locking piece to secure the connecting member in place in humeral head 10 at a desired degree of eccentricity.
  • Figure 3 shows a cross-section view of the humeral head and depicts how bore 18 may be eccentrically located in humeral head 10. Threads 30 line bore 18 for engaging with the locking member.
  • Figure 5 illustrates a side view of connecting member 12.
  • first portion 15 is relatively shallow while second portion 16 is relatively deep.
  • first portion 15 is configured to fit into the shallow bore of the humeral head.
  • Second portion 16 is preferably configured for a Morse taper fit with the humeral stem.
  • second portion could be of a dove-tail slot configuration
  • detent 50 is preferably provided in addition to the locking piece.
  • a series of receiving cavities are provided in the bore of the humeral head for engaging detent 50.
  • connecting member 12 may be rotatably adjusted in the bore into predetermined positions.
  • locking piece 14 is of a depth such that both the first portion of the connecting member and locking piece 14 may be inserted into the shallow bore of the humeral head.
  • the outer circumference of locking piece 14 has threads 60 for threadably engaging the bore of the humeral head.
  • Locking piece secures the connecting member in place within the humeral head at a desired eccentricity of the second portion (for engaging the humeral stem) to the humeral head is achieved.
  • Figure 7 provides a top view of locking piece 14.
  • locking piece 14 is generally configured as a ring.
  • any configuration suitable for securing the connecting member in place in the humeral head may be used.
  • notches 74 are along the inside circumference of locking piece 14 for engaging a tool for rotating the locking piece.
  • the second portion for engaging the humeral stem may be adjusted to be positioned centrally or eccentrically on the humeral head.
  • Shallow bore 18 is eccentrically located on the flat face of humeral head 10 and receives first portion 15 of connecting member 12, which is generally shallow and round.
  • Second portion 16, in this embodiment, is a generally conical piece located eccentrically upon and extending conically from first plate-like portion 15.
  • locking piece 14 is fit over first portion 15 of connecting member 12 and threaded into bore 18.
  • a tool may engage notches 74 for adjusting locking piece 14.
  • the eccentricity the humeral head to a portion of the connecting member attachable to the stem may be adjusted in two different ways as provided by the connecting member.
  • First, the bore within the humeral head is non-coaxial with the humeral head.
  • Second, the second portion of the connecting member is non-coaxial with the first portion of the connecting member.
  • a second degree of eccentricity is achieved.

Landscapes

  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Claims (8)

  1. Prothèse d'épaule modulaire destinée au remplacement de la tête humérale d'un humérus, comprenant :
    une tige ayant une extrémité distale destinée à être insérée dans l'extrémité supérieure de la cavité médullaire de l'humérus et une extrémité proximale destinée à entrer en prise avec une tête humérale (10) ;
    une tête (10) destinée à être positionnée dans une cavité glénoïde, la tête (10) ayant, d'un côté, une surface (1) généralement sphérique formée autour d'un axe et, de l'autre côté, une face généralement plate délimitant la surface sphérique ;
    un alésage (18) étant formé dans la face de tête plate, l'alésage (18) comportant un axe qui est non coaxial avec l'axe de la surface généralement sphérique de la tête (10) ;
    un organe de raccordement (12) destiné à raccorder la tête (10) et la tige, l'organe de raccordement (12) ayant une première partie (15) et une seconde partie (16), la première partie (15) étant configurée de manière à être insérée dans l'alésage (18) de la tête (10), l'alésage (18) étant positionné de manière non excentrique, c'est-à-dire non centré, sur la face plate de la tête (10) afin de recevoir l'organe de raccordement (12) et fournir un premier degré d'excentricité ;
    une pièce de verrouillage (14) destinée à verrouiller l'organe de raccordement (12) de manière non rotative à l'intérieur de l'alésage (18) ;
    la seconde partie (16) étant une pièce de raccordement mâle, d'un diamètre sensiblement inférieur à la première partie (15), qui s'étend de manière conique à partir de la première partie (15) et s'emboîte dans une cavité conique de la tige pour un emboîtement de cône Morse, caractérisée en ce que la seconde partie (16) s'étend selon un décalage axialement parallèle par rapport à la première partie (15) afin de fournir un second degré d'excentricité par la relation entre la seconde partie (16) et la première partie (15).
  2. Prothèse selon la revendication 1, dans laquelle la première partie (15) de l'organe de raccordement (12) est configurée de façon à être insérée en rotation dans l'alésage (18) axial de la tête humérale (10), afin de permettre un ajustement de la seconde partie (16) de l'organe de raccordement (12) par rapport à l'axe de la partie sphérique.
  3. Prothèse selon la revendication 1, dans laquelle la seconde partie (16) de l'organe de raccordement (12) est une broche faisant saillie comportant un cône Morse.
  4. Prothèse selon la revendication 1, dans laquelle l'alésage de la tête humérale (10) et la pièce de verrouillage (14) sont filetés de façon à entrer en prise.
  5. Prothèse selon la revendication 1, dans laquelle la pièce de verrouillage (14) est une bague de verrouillage comportant un alésage ménagé à travers celle-ci avec une surface interne et un épaulement périphérique mettant en prise la première partie (15) de l'organe de raccordement (12).
  6. Prothèse selon la revendication 5, dans laquelle au moins une rainure est pratiquée le long de la surface interne de la bague afin de recevoir un outil destiné à ajuster la bague.
  7. Prothèse selon la revendication 1, dans laquelle la pièce de verrouillage (14) comporte une surface de mise en prise avec un outil afin de recevoir un outil destiné à ajuster la pièce de verrouillage (14).
  8. Prothèse selon la revendication 1, comprenant en outre un cliquet formé sur la première partie (15) de l'organe de raccordement (12) et une série d'évidements formés à l'intérieur de l'alésage (18) axial de la tête humérale (10) destinés à entrer en prise avec le cliquet afin de permettre à l'organe de raccordement (12) d'être ajusté de manière rotative par rapport à la tête humérale (10) dans des positions prédéterminées.
EP02719525.4A 2001-04-19 2002-04-19 Tete d'humerus modulaire a connecteur excentrique Expired - Lifetime EP1427357B8 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US09/838,698 US20020156534A1 (en) 2001-04-19 2001-04-19 Modular humeral head with eccentric connector
US838698 2001-04-19
PCT/US2002/012440 WO2002085259A1 (fr) 2001-04-19 2002-04-19 Tete d'humerus modulaire a connecteur excentrique

Publications (3)

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EP1427357A1 EP1427357A1 (fr) 2004-06-16
EP1427357B1 true EP1427357B1 (fr) 2014-03-26
EP1427357B8 EP1427357B8 (fr) 2014-06-11

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ID=25277826

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EP02719525.4A Expired - Lifetime EP1427357B8 (fr) 2001-04-19 2002-04-19 Tete d'humerus modulaire a connecteur excentrique

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US (1) US20020156534A1 (fr)
EP (1) EP1427357B8 (fr)
WO (1) WO2002085259A1 (fr)

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Also Published As

Publication number Publication date
WO2002085259A1 (fr) 2002-10-31
US20020156534A1 (en) 2002-10-24
EP1427357A1 (fr) 2004-06-16
EP1427357B8 (fr) 2014-06-11

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